SELLER'S DISCLOSURE OF PROPERTY CONDITION CONCERNING THE PROPERTY AT: ____________________________________________________________ (Street Address and City) THIS NOTICE IS A DISCLOSURE OF SELLER'S KNOWLEDGE OF THE CONDITION OF THE PROPERTY AS OF THE DATE SIGNED BY SELLER AND IS NOT A SUBSTITUTE FOR ANY INSPECTIONS OR WARRANTIES THE PURCHASER MAY WISH TO OBTAIN. IT IS NOT A WARRANTY OF ANY KIND BY SELLER OR SELLER'S AGENTS. Seller [choose one:] _____is _____is not occupying the Property. If unoccupied, how long since Seller has occupied the Property? _____________________________________________________________ 1. The Property has the items checked below [Write Yes (Y), No (N), or Unknown (U)]: ____ Range ____ Oven ____ Microwave ____ Dishwasher ____ Trash Compactor ____ Disposal ____ Washer/Dryer Hookups ____ Window Screens ____ Rain Gutters ____ Security System ____ Fire Detection Equipment ____ Intercom System ____ TV Antenna ____ Cable TV Wiring ____ Satellite Dish ____ Ceiling Fan(s) ____ Attic Fan(s) ____ Exhaust Fan(s) ____ Central A/C ____ Central Heating ____ Wall/Window Air Conditioning ____ Plumbing System ____ Septic System ____ Public Sewer System ____ Patio/Decking ____ Outdoor Grill ____ Fences ____ Pool ____ Sauna ____ Spa ____ Hot Tub ____ Pool Equipment ____ Pool Heater ____ Automatic Lawn Sprinkler ____ Fireplace(s)/Chimney (Wood) ____ Fireplace(s)/Chimney (Mock) ____ Gas Lines (Nat./LP) ____ Gas Fixtures Garage: ___Attached ___Not Attached ____ Carport Garage Door Opener(s): ____ Electronic ____ Control(s) Water Heater: ____ Gas ____ Electric Water Supply: ____ City ____ Well ____ MUD ____ Co-op Roof Type: ______________________________ Age: ______________________________ (approx) Are you (Seller) aware of any of the above items that are not in working condition, that have known defects, or that are in need of repair? [choose one:] ____Yes ____No ____Unknown. If yes, then describe. (Attach additional sheets if necessary): ______________________________________________________________________________ ________ ______________________________________________________________________________ ________ ______________________________________________________________________________ ________ 2. Are you (Seller) aware of any known defects/malfunctions in any of the following? [Write Yes
(Y) if you are aware, write No (N) if you are not aware.] ____ Interior Walls ____ Ceilings ____ Floors ____ Exterior Walls ____ Doors ____ Windows ____ Roof ____ Foundation/Slab(s) ____ Basement ____ Walls/Fences ____ Driveways ____ Sidewalks ____ Plumbing/Sewers/Septics ____ Electrical Systems ____ Lighting Fixtures ____ Other Structural Components (Describe): ______________________________________________________________________________ ________ ______________________________________________________________________________ ________ ______________________________________________________________________________ ________ If the answer to any of the above is yes, explain. (Attach additional sheets if necessary): ______________________________________________________________________________ ________ ______________________________________________________________________________ ________ ______________________________________________________________________________ ________ 3. Are you (Seller) aware of any of the following conditions? Write Yes (Y) if you are aware, write No (N) if you are not aware. ____ Active Termites (includes ____ Termite or Wood Rot Damage ____ Previous Termite Damage wood destroying insects) Needing Repair ____ Previous Termite Treatment ____ Previous Flooding ____ Improper Drainage ____ Water Penetration ____ Located in 100-Year Floodplain ____ Present Flood Insurance ____ Prior Structural/Roof Repair ____ Hazardous or Toxic Waste ____ Asbestos Components ____ Urea-formaldehyde Insulation ____ Radon Gas ____ Lead Based Paint ____ Aluminum Wiring ____ Previous Fires ____ Unplatted Easements ____ Landfill, Settling, Soil ____ Subsurface Structure or Pits Movement, Fault Lines If the answer to any of the above is yes, explain. (Attach additional sheets if necessary): ______________________________________________________________________________ ________ ______________________________________________________________________________ ________ ______________________________________________________________________________ ________ 4. Are you (Seller) aware of any item, equipment, or system in or on the Property that is in need of repair? ____Yes (if you are aware) ____No (if you are not aware). If yes, explain (attach additional sheets as necessary).
______________________________________________________________________________ ________ ______________________________________________________________________________ ________ ______________________________________________________________________________ ________ 5. Are you (Seller) aware of any of the following? Write Yes (Y) if you are aware, write No (N) if you are not aware. ____ Room additions, structural modifications, or other alterations or repairs made without necessary permits or not in compliance with building codes in effect at that time. ____ Homeowners' Association or maintenance fees or assessments. ____ Any "common area" (facilities such as pools, tennis courts, walkways, or other areas) co-owned in undivided interest with others. ____ Any notices of violations of deed restrictions or governmental ordinances affecting the condition or use of the Property. ____ Any lawsuits directly or indirectly affecting the Property. ____ Any condition on the Property which materially affects the physical health or safety of an individual. If the answer to any of the above is yes, explain. (Attach additional sheets if necessary): ______________________________________________________________________________ ________ ______________________________________________________________________________ ________ ______________________________________________________________________________ ________ _________________________________________ _________________________________________ Date Signature of Seller Date Signature of Seller The undersigned purchaser hereby acknowledges receipt of the foregoing notice. _________________________________________ _________________________________________ Date Signature of Purchaser Date Signature of Purchaser